The patron saints of breast disease

Throughout the Christian era, saints have been adopted as patrons of countries and towns, trades and professions, and also for protection against disease. Although patronage is usually related to the saint's most spectacular cure or mode of death, sometimes it derives from a play on words, an unusual physiognomy or mistaken identity. Historical research has identified 295 patrons of specific diseases. Thirteen of these saints are patrons of breast disease. St Agatha, who was martyred by mastectomy, being the most famous. The lives, legends, cults and pictorial representations of these saints are described.     

离子通道与阴茎勃起

近年研究发现某些疾病是离子通道基因缺陷与功能变异的结果 ,称为离子通道病。许多疾病虽然不属于离子通道病 ,但疾病发生的某一环节或阶段与离子通道的功能障碍有着密切的关系 ,而且还发现许多药物防治疾病是通过作用于离子通道起效的。因此 ,生理和疾病与离子通道关系的研究逐渐成为当前研究的热点之一。本文简要综述了近年来离子通道与阴茎勃起关系的研究进展。     

表现为痤疮样皮疹的非痤疮皮肤病

寻常性痤疮是临床上最常见的皮肤病之一。通常无需辅助检查可根据临床表现做出诊断。但是,临床上存在某些表现为痤疮样皮疹或以痤疮为表现之一的其他疾病,常与痤疮混淆而引起诊断错误。痤疮样皮疹可由服用药物导致,也可作为一些罕见疾病的皮肤受累表现而出现,此类疾病诊断通常较为困难。为了对此类疾病有更深入的了解,本文对表现为痤疮样皮疹的非痤疮皮肤病进行综述如下。     

离子通道与弱精子症

弱精子症是引起男性不育的常见病因之一。随着以精子自身为对象的研究深入,发现离子跨膜转运对精子的生理活动起着重要的作用。离子通道病于20世纪90年代提出,现已逐渐发现临床上许多先天性和/或后天获得性疾病与异常的离子通道有关。因此,关于精子的生理和疾病与离子通道的关系研究逐渐成为当前研究的热点之一。现就近年来与精子运动相关的离子通道,包括阳离子通道和阴离子通道的研究进展作一综述。     

Lessons from transplantation and future perspectives

Abstract Organ transplantation is now a routine treatment for a number of chronic kidney, heart, lung, and liver diseases. We have accumulated much knowledge about these treatments in the respective disciplines, and it seems appropriate to reflect on some general “across-the-border” lessons that may be important for medicine as a whole. The natural history of several diseases has been extended; however, we have also learned much about temporary organ replacement, with the possibility of treating and, perhaps, also preventing some diseases in ways that were not possible in the past. This study explores the phenomenon of temporary organ replacement, whereby organs that are in danger of losing their function may recover in quiescence. It raises the question of whether there might be a common, underlying mechanism - such as apoptosis - for some very different diseases. Pharmacological interventions designed to modulate apoptosis are being developed that will hopefully reduce the amount of time needed for organs to recover their function. We have learned some lessons, but are there more possibilities that need to be explored?     

心血管疾病与骨质疏松

心血管疾病与骨质疏松症是老年人的常见病和多发病。近年来研究发现两者有相似的治疗和发病机制。笔者从基础研究、临床试验结果等方面,对近年来有关心血管疾病与骨质疏松症之间的关系的最新进展作一简单综述。     

郴州地区各级医院儿科状况及住院儿童疾病谱分析

目的了解郴州地区各级医院儿科门诊、住院的设置及儿科医师的分布,分析住院儿童疾病的类型,为儿科建设和儿童疾病防治提供帮助。方法调查郴州地区77家医院儿科设置情况,收集2008～2010年各县、市、乡镇医院,民营医院病案统计室疾病分类统计报表及病案首页信息库和出院病人登记本,采用国际（ICD-10）标准分类,用病案统计软件对病案首页信息进行分析。结果 77所医院均设置有儿科或内儿科门诊,单独设置儿科住院部的有23所,占29.87%;儿科与内科一起设置为内儿科住院部的有36所,占46.75%;缺儿科住院部的有17所,占22.08%;儿童医院专科医院1所,占1.3%;注册的儿科医师361名。近3年住院儿童疾病排在前5位的疾病依次为呼吸系统疾病、消化系统、新生儿疾病、小儿外伤、烧伤及传染性疾病,这5种疾病占了总数的63.78%。结论郴州地区各级医院设置了儿科门诊,部分设有住院部,儿科医生相对偏少,在儿童疾病谱中,以呼吸系统疾病和消化系统疾病为主,要加强此类疾病的防治。     

Tropical diseases and anaesthesia

The range of infectious diseases encountered while working overseas in resource limited settings varies enormously depending on where in the world one is working, although the majority of low and middle income countries lie within the tropics. Human immunodeficiency virus (HIV), tuberculosis (TB) and malaria are commonly encountered when working in tropical countries and may have an impact upon anaesthesia, either as a direct result of the condition or due to interaction with the drugs used in its management. Other infections such as dengue are less likely to be encountered in a patient undergoing anaesthesia, but may be seen in patients in a high dependency or intensive care unit. Furthermore, the chronic effects of some of these diseases may impact upon anaesthesia or have complications that require surgery. It is essential therefore that the anaesthetist working within these populations has an appreciation of the tropical diseases that are endemic, set against the wider backdrop of a resource-limited population where malnutrition, poorly managed non-communicable disease and trauma may all complicate the clinical picture.     

Tropical diseases and anaesthesia

The range of infectious diseases encountered whilst working in resource-limited settings varies enormously depending on where in the world one is working, although the majority of low- and middle-income countries lie within the tropics. Human immunodeficiency virus (HIV), tuberculosis (TB) and malaria are commonly encountered when working in tropical countries and may have an impact upon anaesthesia, either as a direct result of the condition, or due to interaction with the drugs used in its management. Other infections, such as dengue, are less likely to be encountered in a patient undergoing anaesthesia but may be seen in patients in a high-dependency or intensive-care unit. Furthermore, the chronic effects of some of these diseases may impact upon anaesthesia or have complications that require surgery. It is essential therefore that the anaesthetist working within these populations has an appreciation of the tropical diseases that are endemic, set against the wider backdrop of a resource-limited population where malnutrition, poorly managed non-communicable disease and trauma may all complicate the clinical picture.     

Genetics and CKD

The diagnosis of hereditary monogenic kidney diseases is frequently delayed, in part because of physicians' unfamiliarity with the relatively rare conditions or because of the late onset of symptoms in some patients. Molecular biology methods have clarified the underlying mutations in several types of CKD, and in the process have revealed previously unknown genes and pathogenetic pathways. Mutations affecting the integrity of the glomerular filtration barrier cause proteinuria or nephrotic syndrome; different types of Alport syndrome are caused by mutations in glomerular basement membrane type IV collagen; dysfunction of the primary cilium of tubule cells may lead to a variety of inherited progressive tubulointerstitial diseases; atypical hemolytic-uremic syndrome is frequently caused by inherited complement deficiencies; and progressive kidney injury develops in many inherited systemic or metabolic disorders. Some genetic diseases may not manifest until late childhood or adulthood. Accurate diagnosis is important for appropriate treatment, prognosis, genetic counseling, and possible renal transplantation.     

Osteoporosis Associated with Epilepsy and the Use of Anti-Epileptics—a Review

The increased rate of fractures associated with epilepsy has been long recognised but remains incompletely understood. Study quality and study results have varied, with some but not all studies showing bone diseases including osteoporosis and/or osteomalacia, and a high prevalence of vitamin D insufficiency and deficiency are also noted. Falls risk can also be higher in patients with epilepsy taking anti-epileptic medications, potentially leading to fracture. Larger research collaborations are recommended to further advance understanding in this field, particularly to examine underlying genetic and pharmacogenomic associations of epilepsy and anti-epileptic medication usage and its association with bone diseases and fractures, as well as further investigation into optimal management of bone health in epilepsy.     

Acupuncture and kidney disease

Acupuncture as a complex therapeutic system has been used to treat a variety of diseases and pathological conditions. Although the exact mechanism(s) of acupuncture remains unknown, some evidence suggests a mechanism initially involving signal transduction through connective tissue, with secondary involvement of other systems including the nervous system. Acupuncture has become increasingly popular in the Western countries as a therapy for pain and several chronic disorders difficult to manage with conventional treatments. Acupuncture and acupuncture-like somatic nerve stimulation have been used in different kidney diseases and several complications related to them. The effect of acupuncture techniques in some kidney diseases is reviewed on the basis of clinical reports as well as mechanisms that may possibly explain the beneficial effects mediated by acupressure/acupuncture. The potential effect of acupressure techniques in renal inflammation and whether these effects could be mediated through the newly identified cholinergic anti-inflammatory pathway are discussed.     

Genetic causes of male infertility

Summary.  Male infertility has often been ascribed to infections, immunologic factors, chemical insults or malformations. About 10% of infertile males have severe defects in sperm production. Lately, research has focused on possible genetic aetiologies. In this review genetic causes of male infertility are discussed. For pragmatic reasons three groups have been defined. In the first group, disorders of sexual differentiation associated with male infertility are considered. In the second group, male infertility is discussed in a context of some genetic diseases. In the third group, genetic causes for isolated defects of sperm production and function are reported.     

Obesity and immune function

The perspective of obesity as a low grade systemic inflammatory condition has triggered a new interest on the many overlapping areas between this pathology and the immune system. White adipose tissue production of proteins related to the immune function has shown that many of these adipokines are implied in the ethiopathogenesis of some of the major metabolic diseases such as diabetes, hypertension, cardiovascular diseases, which share with obesity an important role in the Metabolic Syndrome. Besides, dysregulation of immune system may be present due to a dysregulation in the factors produced by adipose tissue. Weight loss through diet or surgery has proved to be beneficial for the recovery of the physiological levels of some of these pro-inflammatory molecules, but other studies are needed to clarify to which extent its possible to pursue risk reduction by this way.     

转运RNA衍生片段在疾病中的作用及其机制研究进展

转运RNA(tRNA)是将信使RNA(mRNA)翻译成蛋白质的关键分子,研究表明它还是一些非编码小RNA的前体RNA。近年来,人们发现在细菌、真菌、植物和动物中存在一些长约16~60 nts的非编码RNA(ncRNA),它们是由tRNA精确剪切而来的片段(tRF),并非是随机降解的产物。目前人们对这类小分子RNA的认识还很有限,近年的研究表明tRF在各种疾病中具有重要的功能。本文针对tRF的分类、修饰及其在各种疾病中的作用及机制等研究进展进行综述。     

Transition from pediatric to adult health services: the perioperative care perspective

Increasing numbers of children with congenital and chronic diseases are surviving beyond adolescence. Consequently, arrangements must be put in place to ensure that these groups of patients continue to receive high-quality care into adulthood. Although some medical disciplines have reacted positively to this growing challenge, perioperative care has lagged behind. This review explores some of the difficulties in delivering optimal perioperative care in the transitional period. Key issues, including the paucity of experience in the management of pediatric diseases among adult-trained clinicians and unfamiliarity with child/family focused care, are discussed. We provide some suggestions for the development of transitional healthcare policies.     

Crutch art painting in the Middle Ages as orthopaedic heritage (part II: the peg leg,the bent-knee peg and the beggar)

Little of historical value about crutches can be ascertained before the Middle Ages. In contrast, the Middle Ages offer many examples for the study of crutches. Even if no medical report can be found, the immense patronage of the Church, encouraging artists to portray the saints and their miracles, has left great masterpieces that drew people with crutches. Pictures and the history of medieval conceptions of disability appear to provide an interesting chronicle of surgery of the peg leg and the bent-knee peg among the representations of cripples and beggars.     

Liver transplantation: current status and future prospects

The enormous progress that has been made in liver transplantation over the past two decades has culminated in survival approaching 90% at 12 months. The success of the procedure combined with the widening spectrum of disease processes deemed amenable to liver transplantation has meant that there are too few donors for those awaiting transplantation. This has extrapolated to many patients having such advanced disease by the time a suitable donor liver is available, that they are almost non-transplantable. The immediate options facing the transplant community are to decrease the number of patients listed or to increase the number of living donor transplants. Alternatives to liver transplantation such as hepatocyte transplantation, gene therapy, xenotransplantation and the bioartificial liver are being sought but, at best, are some way from clinical application. It is anticipated that a number of liver diseases that are indications for liver transplantation at this time will have progression arrested or will be cured by medical therapy in the future.     

甲状腺疾病和乳腺癌相关性研究的进展

内分泌功能的变化和相关疾病的发生有着密切的关系.甲状腺与乳腺同属激素依赖性器官,甲状腺疾病与乳腺癌之间存在着一些共同的致病危险因素,乳腺癌患者多并发甲状腺形态学、病理学及功能改变.尽管甲状腺疾病与乳腺癌之间相关性的研究已有一定深入,但其结果却不甚一致,相关机制仍不十分明确.     

Decontamination of anaesthetic equipment

Awareness that some diseases are transmissible has existed forcenturies. Hippocrates in 450 BC used wine or boiled water toirrigate wounds and, in the second century, Galen was reportedto have boiled his instruments before use. In the middle ages,people suffering with leprosy and the severely ill were isolatedfrom the local population. However, modern infection controlwas only started in the 19th century as a consequence of thework of Pasteur, Lister and other pioneers.